Unit 3- Renal Flashcards
(110 cards)
1
Q
Structural Units of Kidney
A
Renal corpuscle of glomerulus and Bowman’s capsule, tubules, interstitium, and vasculature
2
Q
Glomerular Filtration Barrier
A
Filter plasma, formed by endothelial cells, basement membrane, and podocytes
3
Q
Requirements of Renal Function
A
Adequate perfusion, renal tissue, and elimination of urine
4
Q
Renal Disease Progression
A
Affects multiple components of the kidney, leading to CRF and end stage kidneys
5
Q
Outcome of Renal Disease
A
Imbalance of salt and water, acids and base, and retention of waste
6
Q
Index of Kidney Failure
A
Retention of urea or creatinine
7
Q
Uremia
A
Failure to excrete metabolic waste
8
Q
Edema
A
Failure to maintain normal concentrations of salt and water
9
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Acidosis
A
Failure to regulate acid base balance
10
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Hormone Imbalance
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Failure to produce erythropoietin, renin, and postaglandins leading to anemia, hypertension, and ischemic necrosis
11
Q
Hypercalcemia
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Failure to activate vitamin D
12
Q
Acute vs Chronic Failure
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75% or more function impairement
13
Q
Prerenal Acute Failure
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Transient hypoperfusion
14
Q
Postrenal Acute Failure
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Obstruction of urinary tract
15
Q
Renal Acute Failure
A
Acute glomerulonephritis, acute interstitial nephritis, acute tubular necrosis
16
Q
Acute Tubular Necrosis
A
Caused by nephrotoxins or ischemia, causes oliguria and anuria, pallor
17
Q
Death by Acute Failure
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Increase in serum K causes cardiotoxicity, metabolic acidosis, and pulmonary edema
18
Q
Chronic Renal Failure
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Loss of nephrons and scarring, PU/PD, alteration in calcium/phosphorus metabolism, nonregenerative anemia, increase in PTH secretion, and fibrous osteodystrophy and soft tissue calcification
19
Q
CKD Histology
A
Mononuclear inflammation, interstitial fibrosis, tubular atrophy and loss, glomerulosclerosis, thickened Bowman’s capsule, and tubular and glomerular ectasia
20
Q
Azotemia
A
Elevation of blood urea or creatinine without renal disease
21
Q
Uremia
A
Urine in blood, clinical syndrome of renal failure, extrarenal lesions
22
Q
Uremic Gastropathy
A
Dog and cat, ulcer and hemorrhage secondary to vasculitis, mucosal calcification secondary to Ca/P metabolism
23
Q
Uremic Colitis
A
Horse and cattle, ulcers and hemorrhage secondary to vasculitis
24
Q
Soft Tissue Mineralization
A
Altered calcium/phosphorus metabolism, occurs in parietal pleura, intercostals, larynx, and nephrocalcinosis
25
Pulmonary Edema
Uremic pneumonitis, due to increased vascular permeability
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Ulcerative Glossitis
Ammonia production by bacteria from salivary urea causes vasculitis
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Necrotizing Glossitis
Fibrinoid necrosis of arterioles leads to infarct
28
Uremic Endocarditis
Left atrium, endothelial damage leads to increased vascular permeability
29
Parathyroid Hyperplasia
Altered calcium-phosphorus metabolism, systemic calcification, chief cells try to lower blood calcium by secreting PTH and become hyperplastic
30
Fibrous Osteodystrophy
Secondary to parathyroid hyperplasia, osteoclasts releasing Ca2+ are replaced by fibrous tissue, rubber jaw
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Renal Agenesis
No recognizable renal tissue, inherited in beagle, sheepdog, and doberman
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Renal Hypoplasia
Incomplete renal development, 50% smaller kidney with no renal disease, other kidney has incidental compensatory hypertrophy
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Renal Dysplasia
Malformation of renal parenchyma
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Juvenile Nephropathy
Non inflammatory degenerative or development of chronic renal disease in young animals
35
Familial Nephropathy
Genetic inheritance of nephropathy, clinical sign onset varies
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Asynchronous Maturation
Structures in nephrogenesis not normal in infants; primitive ducts, fetal glomerulus
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Fused Kidneys
Horseshoe kidney fused during nephrogenesis, incidental
38
Congenital Cysts
Incidental, polycystic kidney disease in cats
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Acquired Cysts
Tubules or glomeruli obstructed by scar tissue, extensive interstitial fibrosis
40
Feline Polycystic Kidney
Autosomal dominant in persians, cysts in nephron present in pancreas and liver
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Glomerular Filtration
Small particles pass through and are reabsorbed to maintain homeostasis, proteins remain in blood
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Proteinuria
Abnormal quantities of protein in urine, indication or glomerular or tubular injury
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Albuminuria
Albumin leaking into urine, leads to edema, ascites, hydrothorax, and hydropericardium
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Loss of Antithrombin III
Leads to hypercoagulable state and thrombi
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Hallmarks of Glomerular Disease
Proteinuria, hypercoagulable state, nephrotic syndrome
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Nephrotic Syndrome
Proteinuria, hypoalbuminemia, generalized edema, hypercoagulable state, hyperlipidemia
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Hyperlipidemia in Glomerular Disease
Liver overproduces albumin to compensate for loss, producing cholesterol
48
Glomerulitis
Inflammation restricted to glomerulus during acute septicemia
49
Glomerulonephritis
Glomerular disease and secondary tubulointerstitial and vascular changes, immune origin
50
Glomerulitis in Foals
Actinobacillus equuli causes septicemia
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Dog Glomerulonephritis
Pyometra, pyoderma, chronic parasitism, autoimmune, neoplasia
52
Cat Glomerulonephritis
FeLV, FIV, FIP
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Immune Glomerulonephritis
Circulating antigen-antibody complexes from persistent infection trapped in capillary wall
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Injury to Glomerular Structures
Deposition of immune complexes, complement activation, chemotaxis of neutrophils, damage to basement membrane by neutrophils
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Outcome of Glomerular Injury
Proliferation of mesangial cells and podocytes, influx of inflammatory cells, thickening of mesangial matrix and basement membrane
56
Membranous Glomerulonephritis
Thickened glomerular basement membrane and mesangial matrix, common in cat
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Proliferative Glomerulonephritis
Hypercellularity and influx of WBC
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Membranoproliferative Glomerulonephritis
Thickened basement membrane and matrix and cellular proliferation, common in dog
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Gross Glomerulonephritis
Enlarged glomeruli give granular appearance
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Dog Membranoproliferative Glomerulonephritis
Borrelia, dirofilaria, pyometra, pyoderma, lupus
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Car Membranous Glomerulonephritis
FeLV, FIP, FIV
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Horse Membranoproliferative Glomerulonephritis
Strep equi, equine infectious anemia
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Pig Membranoproliferative Glomerulonephritis
PCV-2
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Amyloid
Extracellular, homogenous, insoluble, fibrillar protein resistant to degradation
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Primary AL Amyloidosis
Plasma cell tumors create immunoglobulin light chain protein
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Secondary AA Amyloidosis
Chronic inflammation creates serum amyloid in liver, most common in domestic animal
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Familial Amyloidosis
Shar-pei, abysinnian, and siamese
68
Amyloidosis
In mesangium and subendothelial glomerular capillaries or in medulla in familial disease, develop renal insufficiency and proteinuria
69
Glomerular Amyloidosis
Pale granular appearance, amyloid in mesangium and subendothelial glomerular capillaries, confirmed by congo red stain
70
Sequelae to Glomerulonephritis
Glomerulosclerosis, downstream tubular ischemia and injury, interstitial fibrosis
71
Hyaline Casts
Protein filling tubules, indicative of glomerular disease
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Renal Infarction
Localized coagulative necrosis
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Renal Obstructive Material
Thrombi from hypercoagulable state, septic emboli, neoplastic emboli
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Predisposition to Renal Infarct
Valvular endocarditis, feline hypertrophic cardiomyopathy, endotoxemia, neoplasia
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Renal Artery Infarction
Entire kidney will be necrotic
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Arcuate Artery Infarction
Wedge Shaped necrosis of cortex and medulla
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Interlobular Artery Infarction
Necrosis of cortex
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Renal Necrosis Causes
Ischemia from NSAID, medullary amyloidosis, pyelonephritis, or pelvic calculi or tumor
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NSAID Pathogenesis
Block prostaglandin production, ischemia of renal medulla leads to necrosis
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Analgesic Nephropathy
Dehydrated horses treated with phenylbutazone NSAID develop papillary necrosis
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Acute Tubular Necrosis
Most common cause of renal failure, toxic or ischemic and resulting in oliguria and anuria
82
Nephrotoxic Tubular Necrosis
Toxins leave basement membrane intact, so epithelium heals by regeneration
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Ischemic Tubular Necrosis
Basement membrane is damaged, so heals by fibrosis
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Nephrotoxins
Hemoglobin, myoglobin, lead, aminoglycoside antibiotics, NSAIDs, fungal toxins, pigweed toxins, oxalates, oak tannins, ethylene glycol antifreeze, vit D, bacterial toxins
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Hemoglobinuric Nephrosis
Accumulates in tubules, causes intravascular hemolysis
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Chronic Copper Toxicity in Sheep
Coagulative necrosis of tubular epithelium, orange granular casts in tubules, diffuse dark discoloration
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Myoglobinuric Nephrosis
Extensive muscle necrosis releases myoglobin that is filtered and toxic to tubules
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Cholemic Nephrosis
Hepatic failure leads to icterus and bile cast nephropathy, kidney will be colored green
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Lead Toxicity
Acid fast intranuclear inclusion bodies in epithelial cells, damages membranes of epithelial cells and mitochondria
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Ethylene Glycol Toxicity
Oxidized in liver into toxic metabolites that cause ATP depletion and membrane damage, characteristic calcium oxalate crystals
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Ischemic Renal Tubule Damage
Decreases volume of blood going through kidneys
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Inflammatory Tubulointerstitial Disease
Secondary to acute tubular necrosis or glomerulonephritis, septicemia infecting the tubules, leptospira, or chronic inflammation
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Clinical Character of Inflammatory Tubulointerstitial Disease
Loss of concentrating urine
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Nonsuppurative Interstitial Nephritis
Leptospirosis, white spotted kidney in calf, toxocara canis, malignant catarrhal fever, FIP, lyme, hairy vetch
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Nonsuppurative Interstitial Nephritis Histology
Lymphoplasmacytic infiltration, interstitial fibrosis, tubular dilation and atrophy
96
White Spotted Kidney in Calf
Incidental finding in calf related to bacteremia, random distribution indicates hematogenous spread
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Acute Granulomatous Interstitial Nephritis in Puppy
Canine hepesvirus-1 causes multifocal cortical hemorrhage due to tubular necrosis and hemorrhage
98
Suppurative Embolic Nephritis
Microabscesses in renal cortex, septic omphalophlebitis or endocarditis
99
Pyelonephritis
Inflammation of renal pelvis and parenchyma, ascending UTI
100
How does bacteria reach renal pelvis?
Abnormal vesicoureteral reflux, reverse peristalsis
101
Sequelae to Pyelonephritis
Pyelonephrosis
102
Horse Kidney
Normal to have mucous glands in kidney pelvis
103
Hydronephrosis
Cystic dilatation of pelvis due to obstruction of urine flow, results in pressure atrophy of renal medulla and cortex
104
Halicephalobus gingivalis
Nematode larvae causing granulomatous lesion in horse kidney
105
Primary Neoplasms
Usually bilateral, epithelial, embryonal, or mesenchymal origin
106
Renal Carcinoma
Most common primary renal neoplasm in dog, cattle, and horse, originates from epithelium of proximal tubule, local invasion, highly metastatic
107
Renal Cystadenocarcinoma-Nodular Dermatofibrosis Syndrome
Bilateral multifocal renal cystadenoma and nodular dermatofibrosis with uterin leiomyoma in german shepherds
108
Nephroblastoma
Most common primary renal neoplasm in pig and chicken, metanephric blastema origin, occurs in young animals
109
Ectopic Nephroblastoma
Embryonal renal rests trapped between dura mater and spinal cord at thoracolumbar junction in young dogs
110
Lymphoma
Commonly involved in renal
